West Midlands Neonatal Transfer Service
WMNTS Activity
April 2012-March 2013
Who We Are
West Midlands Neonatal Transfer Service
Operational Policy
Provide 24/7 retrieval service Provide daily back transfer service 9-5 Monday-Friday cot locator service
Retrieve from neonatal units or neonates from BCH/Alder Hey
Transfer numbers
Refusals
Data collection
Types of Transfers
Time critical transfers
Staffing
Clinical Incidents
Budget
Changes
Transfer numbers
Refusals
Data collection
Types of Transfers
Time critical transfers
Staffing
Clinical Incidents
Budget
Changes
West Midlands Neonatal Transfer Service
Transfers 2009-2013
2009-2010 2010-2011 2011-2012 2012-20130
200
400
600
800
1000
1200
1400
1600
18001698
1553
1390
1547
1422
1253
10741180
Requested Performed
West Midlands Neonatal Transfer Service
Activity 2012-13
April
May
June Ju
ly
Augus
t
Septe
mbe
r
Octobe
r
Novem
ber
Decem
ber
Janu
ary
Febru
ary
Mar
ch0
20
40
60
80
100
120
140117
157
121126
133125
143 137 158
123
100107
94
109
82
10298 99
115
101110
97
86 87
Req Trans Prev yr
West Midlands Neonatal Transfer Service
SWMNN SSBCNN CNN Other
Requested 1016 369 48 114
Performed 789 281 23 87
100
300
500
700
900
1100
Activity by Network 2012-2013
Tra
ns
fer
nu
mb
ers
Other includes repatriation from LWH, Alder Hey, Bristol(s), Arrowe Park)
Transfer numbers
Refusals
Data collection
Types of Transfers
Time critical transfers
Staffing
Clinical Incidents
Budget
Changes
REASON FOR NOT UNDERTAKING TRANSFERS
Attributable to NTS Non NTS
Number of Refusals StaffingOn other/ITU calls
Weather/Equipment
Deteriorationof baby
No beds Parents
Inapproprequest
Canc byref unit
Not in ournetwork
Canc by rec unit
SWMNN 71 6 23 3 20 19
SSBCNN 34 15 4 12 3
CNN 15 1 14
Other 7 1 3 3
Total 127 Number of Cancellations
SWMNN 139 40 10 35 4 3 35 1 11
SSBCNN 46 5 3 17 2 1 17 1
CNN 10 1 1 5 2 1
Other 17 7 5 1 3 1
Total 212
Number of Deferrals
SWMNN 17 11 1 1 2 1 1
SSBCNN 8 7 1
CNN 0
Other 3 1 1 1
Total 28
22 92 4 23 67 8 39 57 41 14
West Midlands Neonatal Transfer Service
Transfers performed(1180)/ requested (1547)=
(76%)
But only 118 of those not performed were for WMNTS
reasons
Therefore (1547-118)/1547 could have been
performed by WMNTS = 92% (both networks)
Transfer numbers
Refusals
Data collection - old
Types of Transfers
Time critical transfers
Staffing
Budget
Clinical Incidents
Changes
West Midlands Neonatal Transfer Service
Data Collection April 12-Dec 12
Transferred IPPV Surgical CardiacBack
transfer SpecialistOPD/
RadiologyCot
Mngt Cooling
Transfer numbers
Refusals
Data collection
Types of Transfers - old
Time critical transfers
Staffing
Clinical Incidents
Budget
Changes
West Midlands Neonatal Transfer Service
Medical Transfers 12-13
SSBCNN SWMNN CNN Other Total0
20
40
60
80
100
120
140
160
Medical
Acute
Non Acute
West Midlands Neonatal Transfer Service
Cardiac Transfers
SSBCNN SWMNN CNN Other Total0
10
20
30
40
50
60
70
80
Cardiac Acute
Non Acute
West Midlands Neonatal Transfer Service
Surgical 12-13
SSBCNN SWMNN CNN Other Total0
50
100
150
200
250
SurgicalAcuteNon Acute
West Midlands Neonatal Transfer Service
Surgical Transfers
219
5 3
Within care pathwayOutside care pathwayCare not available in region
West Midlands Neonatal Transfer Service
Specialist 12-13
SSBCNN SWMNN CNN Other Total0
5
10
15
20
25
30
SpecialistAcuteNon Acute
West Midlands Neonatal Transfer Service
Back Transfers 12-13
SSBCNN SWMNN CNN Other Total0
100
200
300
400
500
600
BackTransfersAcuteNon Acute
West Midlands Neonatal Transfer Service
Cot Management
SSBCNN SWMNN CNN Other Total0
10
20
30
40
50
60
70
80
90
100
CotManagementAcuteNon Acute
Transfer numbers
Refusals
Data collection - new
Types of Transfers
Time critical transfers
Staffing
Clinical Incidents
Budget
Changes
Since Jan 13
Replaced by a 4-level categorisation
EVERY inter-hospital neonatal transfer categorised against these categories.
West Midlands Neonatal Transfer Service
BAPM category of care
Intensive Care High dependency care
Special care
Pick ONE
Notes: Transitional care / normal care not included as basic monitoring used for all babies in transfer
West Midlands Neonatal Transfer Service
Primary clinical reason for transfer
Medical Surgical Cardiac Neurological
Pick ONE
Categorise on the intended treatment the infant will receive on completion of transfer.
West Midlands Neonatal Transfer Service
Primary operational reason for transfer
Uplift Resources/Capacity
Repatriation Outpatients
Pick ONENotes:
Uplift: Transfer for care that the referring centre does not normally offer
West Midlands Neonatal Transfer Service
Time
Within 1 hour Within 24 hours
>24 hours
Pick ONE
Use intention to treat throughout. Within what timescale did you set-out to arrange this transfer?
Transfer numbers
Refusals
Data collection
Types of Transfers - new
Time critical transfers
Staffing
Clinical Incidents
Budget
Changes
Example – March 2013ITU 34 Uplift 41
HD 14 Capacity 13
SC 39 Repatriation 33
Out Patients 0
Medical 56
Surgical 22 Within 1 hr 2
Cardiac 1 Within 4 hrs 37
Neuro /cooling 8 (1+7) Within 24 hrs 47
>24 hours 1
Transfer numbers
Refusals
Data collection
Types of Transfers
Time critical transfers
Staffing
Clinical Incidents
Budget
Changes
West Midlands Neonatal Transfer Service
Clinical criteria for categorising as Time Critical
1. Gastroschisis2. Ventilated infant with Tracheo-oesophageal fistula +/- atresia3. Intestinal perforation4. Suspected duct-dependent cardiac lesion not responding to
prostin5. Unstable respiratory or cardiovascular failure not responding
to appropriate management: Despite giving appropriate ventilation via endotracheal tube the
infant’s respiratory status remains unstable or severely compromised:
persistent unstable pneumothorax despite chest drain requiring FiO2 100%
arterial oxygen < 5kPa on 2 consecutive blood gas measurements pH <7.1 and pCO2 >9kPa persistent mean blood pressure below corrected gestational age,
measured on arterial line; if measured with cuff only, there should also be acidosis (pH <7.1)
Time Critical TransfersNIC01 - WMNTS Transfer Response Time
Response Times *or if born >same day, time call received
Date DiagnosisReferring Hospital
Receiving Hospital Vent mode
Time Baby Born
Time callreceived
Time callaccepted
Time team left base
Miles toref unit
Arrived refhospital
Miles to rec unit
Depart refhospital
Arrived rechospital
Total time (time born* - rec hosp) Comments
20.04.12 Perforated NEC Heartlands Alder Hey PICU IMV 09:04 15:50 15:55 16:15 8 16:40 98 18:35 20:20 11hrs 16minsAlderhey PICU bed lost upon arrival;theatre bed made available after 1.5 hours
30.04.12 Gastroschisis B'ham Women's BCH NNSU SVIA 11:25 11:55 11:55 12:05 0 12:10 4 13:25 13:55 2hrs 30minsDelay due to haematoma requiring Consultant review. Roadworks delayed journey outside BCH, Consultant in theatre when team arrived
06.05.12 Gastroschisis B'ham Women's BCH NNSU SVIA 12:59 13:40 13:40 13:40 0 13:45 4 14:50 15:15 2hrs 16mins
13.05.12 Gastroschisis B'ham Women's BCH NNSU SVIA 10:44 12:50 14:15
Team finished moving other
baby from BCH to BWH14:45 0 14:45 4 15:30 15:50 5hrs 6mins
WMNTS had to move a baby from BCH NNSU first to create cot space for this baby, therefore not able to obtain surgical review within 2 hour timeframe.
14.05.12RDS,Perforated NEC UHNS Alder Hey IMV
On8.05.12 15:15 15:15 16:00 66 17:25 55 19:35 20:40 5hrs 25mins
Team already out on transfer (Redditch) when call received, ambulance needed to be swapped due to broken door. Delay on motorway due to major incident, police contacted for alternative route
18.05.12 Perforated NEC UHNS BCH PICU SIMVOn
13.05.12 18:50 18:50 18:50 49 20:00 45 21:40 22:40 3hrs 50mins Outcome - no perforation, treated conservatively
25.06.12 Perforated NEC Heartlands BCH PICU IMV On 19.06.12 06:35 07:55 08:25 8 09:00 4 10:05 10:25 3hrs 50minsBaby being intubated at the time of first call,handed over to day team
30.06.12 Gastroschisis Shrewsbury Alder Hey PICU SVIA 00:22 01:25 01:25 00:30* 52 01:30 70 03:40 05:15 4hrs 53mins*Team already on site for another transfer, hencetime team left base prior to time call received
19.07.12 Gastroschisis B'ham Women's BCH NNSU SVIA 20:20 21:15 21:15 21:20 0 21:35 4 22:20 22:40 2hrs 20mins
21.07.12 Gastroschisis Heartlands BCH PICU IMV 09:47 10:05 10:10 10:30 8 10:55 4 12:45 13:05 3hrs 18minsBaby not ready and awaited confirmation ofPICU cot
29.07.12 Perforated NEC City Dudley Rd BCH PICU IMVOn
05.06.12 14:00 14:15 14:30 4 14:45 3 16:25 16:45 2hrs 45minsBaby hypothermic due to need for emergency abdo drain insertion. Very unstable baby. RIP 29/07/2012
nothing for August
05.09.12 Perforated NEC Heartlands BCH PICU IMVOn
31.08.12 19:20 19:20 20:25 8 20:45 3 22:40 23:10 3hrs 50mins 13.09.12 Gastroschisis B'ham Women's BCH NNSU SVIA 11:15 12:00 12:00 12:00 0 12:00 4 12:50 13:20 2hrs 5 mins
09.10.12 ?Perforated NEC New Cross BCH PICU IMVOn
06.09.12 12:15 12:15 12:40 16 13:30 16 15:00 15:30 3hrs 15mins 16.10.12 Gastroschisis Walsall Manor BCH NNSU SV 02 17:19 17:00 17:00 17:00 24 17:45 12 19:25 19:50 2hrs 31mins Team diverted from Heartlands transfer 01.11.12 TOF Walsall Manor BCH PICU IMV 00:45 10:10 10:15 10:55 13 11:40 12 13:15 14:00 13hrs 15mins Call not received by NTS until 1010hrs
17.11.12 Gastroschisis B'ham Women's BCH NNSU SVA 00:25 01:10 01:10 02:20 0 02:20 4 03:00 03:30 3hrs 5mins
Call received during on call hours, staffcame in from home (1 hour approximately to travel to workplace from home)
18.11.12 ?Perforated NEC New Cross BCH PICU IMV/NO On 14.11.12 23:40 23:50 00:40 16 01:15 16 02:40 03:30 6hrs 24mins
Call received during on call hours, staffcame in from home (1 hour approximately to travel to workplace from home)
22.11.12?TOF - duodenal atresia Heartlands BCH PICU IMV 07:00 13:30 13:30 14:30 8 15:05 3 16:55 18:00 11hrs Bed not available on PICU until 1600hrs
24.12.12 Gastroschisis B'ham Women's BCH NNSU Inc02 13:37 14:45 14:45 14:45 0 14:45 4 16:00 16:30 2hrs 55mins WMNTS not contacted immediately
02.01.13 Gastroschisis B'ham Women's BCH PICU IMV 05:02 05:45 05:45 06:40 0 06:45 4 09:00 09:20 3hrs 18mins
Call received during on call hours, staff came in from home but baby intubated and required PICU bed, handed over to day team whilst awaiting confirmation of bed
07.01.13 Gastroschisis B'ham Women's BCH NNSW NP02 18:05 19:20 19:20 19:30 0 19:30 4 20:20 20:40 2hrs 35 mins
22.01.13 Perforated NEC Shrewsbury Liverpool IMV unknown 13:10 13:10 14:45 52 15:25 69 16:30 18:30 5hrs 20 mins Time recorded from when call received as time baby born not available
01.02.13 ?Perforation B'ham Women's BCH PICU IMVOn
28.01.13 12:25 12:25 12:25 0 12:30 4 15:25 15:55 3hrs 30mins Baby not ready, required intubation and x-ray
05.02.13 ?Perforated NEC Heartlands BCH PICU IMVOn
04.01.13 04:40 04:40 05:45 8 06:05 3 08:10 08:25 3hrs 45 mins Call received during on call hours
15.02.13 Gastroschsis New Cross BCH PICU SIMV 12:48 13:20 13:20 13:45 16 14:40 16 16:00 16:40 3hrs 52mins Bed not confirmed at time of referral (confirmed at 13:45)
20.02.13 Intestinal perforation UHNS Alder Hey PICU IMVOn
16.02.13 16:00 16:10 16:35 54 18:00 55 19:30 20:45 4hrs 45mins Delay at Alder Hey waiting for baby to go into theatre
27.03.13 Gastroschisis B'ham Women's BCH NNSU SVIA 10:17 11:40 11:45 12:40 0 12:50 4 13:50 14:05 3hrs 48minsDelay due to baby not yet fully admitted to NNU and no discharge paperwork available
28.03.13 ?Intestinal perforation Walsgrave BCH PICU IMV On 16.03.13 15:20 15:30 15:45 30 16:20 26 17:55 18:55 3hrs 35mins Performing transfer on behalf of CenTre team
West Midlands Neonatal Transfer Service
Types of Time Critical Transfers
NEC Gastrochisis TOF0
2
4
6
8
10
12
1413
14
2
No CHD not responding to prostaglandin infusion (4) ; No (5) recorded
West Midlands Neonatal Transfer Service
Meeting standards for time critical transfers
WMNTS dispatch times for all TCT=31 mins (0-95 mins)(n=28)(20 mins if on-call /bed availability etc excluded (n=21))
WMNTS dispatch times for TCT LNU –18 mins (n=3)SCU - 0
Use appropriate neighbouring team if standard cannot be met – KIDS, CenTre (1 performed by KIDS; WMNTS performed 1 for CenTre)
West Midlands Neonatal Transfer Service
Dispatch <1 hour
22
2
2 21
achievedbed not availableshift changeon callteam factors
1 transfer performed for CenTre; 1 transfer performed by KIDS as WMNTS oncall
Geographical Area Covered
West Midlands Neonatal Transfer Service
Travelling times from Base Hospital
Time (mins)
City 18
BCH 19
BHH 24
Russells Hall
26
Redditch 28
Walsall 30
Time (mins)
Good Hope 31
Worcester 34
New Cross 36
Stafford 54
UHNS 67
Hereford 70
Shrewsbury 74
Transfer numbers
Refusals
Data collection
Types of Transfers
Time critical transfers
Staffing
Clinical Incidents
Budget
Changes
West Midlands Neonatal Transfer Service
Staffing
Funding Actual
Consultant 1.3 (0.9, 0.2, 0.3) 1.2
Nurse Consultant (8c) 1 1
ANNP (mid point 8b) 8 3 + 1 secondment ( + 0.5 8a)
ST6 0 Approx 0.5
Band 6 nurses 8 5.0 (3 vacancies advertised)
Band 4 1 1
Band 2 (cot locator) 1 1
Transfer numbers
Refusals
Data collection
Types of Transfers
Time critical transfers
Staffing
Clinical Incidents
Budget
Changes
West Midlands Neonatal Transfer Service
Clinical Incidents
17%
1%
11%
4%
30%
14%
2%
19%
2%
Temperature
Staff shortages
Clinical
NTS incidents
Communication
Ambulance
Staff accident
Equipment
Care Withdrawn
West Midlands Neonatal Transfer Service
Comparison of Incidents
2012/13 2011/12 2010/11 2009/10 2008/090
200
400
600
800
1000
1200
1400
1600
1180
1074
1253
1422
1269
81 73119 113
760.07 0.07 0.08 0.08 0.06
Number of transfers performed Number of incidents reported % incidents vs number of transfers
Types of Incidents
2008/09 2009/10 2010/11 2011/12 2012/130
5
10
15
20
25
30
35
22
2019
26
30
8
18
16
30
19 Temperature
Clinical
Communication
Ambulance
Equipment
Transfer numbers
Refusals
Data collection
Types of Transfers
Time critical transfers
Staffing
Clinical Incidents
Budget
Changes
Pay Non pay£0.00
£200,000.00
£400,000.00
£600,000.00
£800,000.00
£1,000,000.00
£1,200,000.00
Budget
Actual
Budget
Transfer numbers
Refusals
Data collection
Types of Transfers
Time critical transfers
Staffing
Clinical Incident
Budget
Changes
West Midlands Neonatal Transfer Service
Developments over the last 6 months
West Midlands Neonatal Transfer Service
Changes to Working Practice
Team now on site at night tues- thurs – allows overnight planned back transfers
Rotational post between BWH & WMNTS commencing
Succession planning with 2 student ANNPs
West Midlands Neonatal Transfer Service
Ambulance Driver Training
West Midlands Neonatal Transfer Service
New Ambulances
West Midlands Neonatal Transfer Service
West Midlands Neonatal Transfer Service
Parents Travelling with Babies
West Midlands Neonatal Transfer Service
Tecotherm Mattress & Trolley
West Midlands Neonatal Transfer Service
WMNTS Objectives 2013-14
Objective 1: To meet Continuing Professional Development requirements in neonatal transport
Reference Network Objectives
Work Programme Measurement Used Lead Review DateProgress Review
April 2014
SSBCNN Objective 3 SWMNN Objective 4 Toolkit 5
Continue to provide training on Transfer medicine to multi-professional staff in the networks
Attendance record at bi-annual study days, ST Deanery training programme, QIS programme
Alex Philpott Jackie Harrison
On going
To provide outreach programs for Units in the networks
Service delivery, supporting network study days, training packages on web site
Alex Philpott Jackie Harrison
On going
To ensure educational needs for WMNTS staff pertaining to neonatal transport are met
Rolling programme for all WMNTS staff to complete accredited transport course
Alex Philpott Jackie Harrison
On going
Bespoke training to WMAS prehospital neonatal providers
Bespoke training delivered to support regional MLUs/paramedics
Alex Philpott Apr-14
Objective 2: Promote the activities and share the experiences of the NTS with others
Reference Network Objectives
Work Programme Measurement Used Lead Review DateProgress Review
April 2014
SSBCNN Objective 1 SWMNN Objective 1, 2 Toolkit 7.8 + 7.12
Quarterly data to include risk assessment / Near Miss
Report to be generated to each unit and Network Board
Jackie Harrison Q3,4,1,2
Minimise the number of out of region transfers in particular for surgical management
Report to be generated to each unit and Network Board
Jackie Harrison Q3,4,1,2
Monitor and audit babies transferred for cooling
Report to be generated to each unit and Network Board
Q3,4,1,2
Present data to Transfer User Group
Jackie Harrison June 13, Jan 14
Education workstream to be trained in simulation medicine
Record of completion of training for 3 team members; record of participation in network simulations
Alex Philpott June 13, Jan 14
Monitor and audit time critical transfers
Present data to Transfer User Group
Jackie Harrison June 13, Jan 14
Objective 3: To deliver a safe transport service which meets the needs of neonatal services in the West Midlands
Reference Network Objectives
Work Programme Measurement Used Lead Review DateProgress Review
April 2014
SSBCNN Objective 2, 3 SWMNN Objective 6
Continue to support units initiate therapeutic hypothermia
Service delivery Attendance record
Jackie Harrison/ WMNTS Cooling lead
Dec-13
To perform user satisfaction questionnaire
Audit presented at Transfer User Group
Alex Philpott Jackie Harrison
June 13, Jan 14
Training in use of Tecother Mattress and transport device
WMNTS Training record Alex Philpott Jackie Harrison
Jun-13
To provide a transport service for neonatal palliative care referrals
Record kept of palliative care transfers
Alex Philpott Jackie Harrison
Apr-14
Objective 4: To ensure the NTS is appropriately resourced for all neonatal transport activity
Reference Network Objectives
Work Programme Measurement Used Lead Review DateProgress Review
April 2014
SSBCNN Objective 3 SWMNN Objective 2
24 hour dedicated call handling centre
Option appraisal for establishment of call handling centre completed
Alex Philpott Jackie Harrison
Dec-13
Toolkit 4.5
Ensure an adequate number of appropriately trained personnel for NTS by support of student ANNPs and rotation into neonatal units
Monitor staffing levels; Alex Philpott Ongoing
Supporting ST Training during rotation into NTS
ST training programme and feedback from ST
Alex Philpott
Ongoing
West Midlands Neonatal Transfer Service
Terms of Reference
TERMS OF REFERENCE OF THE WEST MIDLANDS TRANSFER USER GROUP (wmTUG)
The group is responsible for:
– Monitoring the effectiveness of the West Midlands Neonatal Transfer Service (WMNTS)
– Identifying transfer issues and future transport requirements within the Networks
– Identifying investment required to achieve a robust transfer service for the Networks
– Making recommendations to the Network Boards to improve transport collectively within the Operational
Delivery Networks (ODN) in line with the recommendations in the Review of Neonatal Intensive Care
Services and the Toolkit for High Quality Neonatal Services
– Implement, review and further develop transfer guideline, protocols and procedures for use across the
Networks
– Make recommendations for standardising transport education and training across the Networks
– Continue to contribute to regional and national discussions relating to developments in neonatal transfers
ACCOUNTABILITY, RESPONSIBILITIES AND PERFORMANCE MANAGEMENT
– The members of the Transfer Group will be accountable to the ODN Boards and are responsible for
providing progress reports to the boards.
– Chair to be rotated between the Transport Consultant Leads, in their absence Transport Nurse Consultant
to chair
– The Chair of the group will be accountable to the 2 ODN Boards for the effective performance of the group.
MEMBERSHIP
– WMNTS team members
– One neonatal medical/nurse representative from each provider Trust
and deputy
– One obstetric/midwifery representative from each provider Trust and
deputy
– A representative from Patient First Ambulance Service
– Network Managers
– Network Practice Educators
– WMNTS Administrator (minute taker)
– Parent user
– SCN/ senate members
– Member of NHS commissioning body
MEETINGS AND PROCEDURES
– The group shall hold meetings as necessary, however unless agreed otherwise, meetings should be held
twice a year. Venue will be rotated between the two networks where possible.
– All meetings shall be arranged and serviced by the WMNTS Administrator hosting the meeting
– Group members will receive written notice of the meeting in the form of a copy of the agenda and relevant
papers, which will be circulated at least 5 working days in advance of the meeting.
– Special meetings may be called as necessary by either the Chair or at least 2 members of the group from
each of the network if it is determined that there are urgent matters to be considered. In such circumstances
the written notice of the meeting may not be less than the prescribed 3 working days.
– Meetings of the Transfer User Group will be deemed quorate if there is 4 representatives from each of the
Networks – if response suggests that the meeting will not be quorate the lead transport consultant/ nurse
consultant may decide to cancel the meeting at short notice unless there are any issues requiring urgent
action
– Every question to be decided at a meeting shall be determined by the majority of votes of members present.
Where there is equal division of votes, the chair shall have a casting vote.
– No matter which the group has agreed may be rescinded or varied at a subsequent meeting unless that
rescission or variation is a specific item of business on the agenda for that meeting.
– Deputies will be encouraged.
– Regular reports and updates on progress made to the ODN Board
West Midlands Neonatal Transfer Service
National Transport Group Conference 2013
Friday 29th November 2013Burlington Hotel Birmingham B2 4JQProgramme of Events
• Welcome• Chairman’s report• The Challenges of Neonates for a Paediatric Intensive Care Retrieval Service• The Australian Transport Service• The Parent’s Perspective• Guest Speaker • Poster Presentations• Close
Hosted by:
AbstractsAuthors are invited to submit audit or research abstracts to [email protected] (see separate application form)
Abstracts can be original research, development of a new guideline or audit. All must have relevance to neonatal transport medicine.Abstracts should state briefly and clearly the purpose, methods, results and conclusions of the work with a maximum word count of 350 words.
Deadline for submission is 30th September 2013
Accepted admissions to be notified by 18th October 2013PricesDelegate rate £100 - day conference fee and dinner
Special team rate £500 - day conference fee and dinner for 5 people + 1 person freeFurther information relating to accommodation, location and local amenities on
separate flyer
West Midlands Neonatal Transfer Service
West Midlands Neonatal Transfer Service
West Midlands Neonatal Transfer Service
West Midlands Neonatal Transfer Service
West Midlands Neonatal Transfer Service
Cooling ActivityApril 2012 ~ March 2013
April May June July Aug Sept Oct Nov Dec Jan Feb Mar0
1
2
3
4
5
6
7
RequestsTransfersRefusal/Cancellation
West Midlands Neonatal Transfer Service
Requests from
BWH
City
Good Hope
Linco
ln
New X
Redditc
h
Russells
Hall
Stafford
Wals
all
Warw
ick
Worce
ster
Hereford
0
2
4
6
8
10
12
West Midlands Neonatal Transfer Service
Transfers requests Per network
CNN
SSBCNN
SMWNN
17
32
2
West Midlands Neonatal Transfer Service
Transfer To
New Cross Heartlands UHNS BWH0
5
10
15
20
25
West Midlands Neonatal Transfer Service
17
• 14
Transfers performed To each network
• 50% of babies were admitted to SSBCNN for therapeutic hypothermia
• 50% of babies were admitted to SWMNN for therapeutic hypothermia
West Midlands Neonatal Transfer Service
Transfers performedReferral age
Within 1 hour
Within 2 hours
Within 3 hours
Within 4 hours
Within 5 hours
Within 6 hours
Greater than 6 hours
0
2
4
6
8
10
12
14
16
18
20
Number of babies
West Midlands Neonatal Transfer Service
Transfers performedResponse time (Call → Arrival on Ref. NNU)
Within 1 hour
Within 2 hours
Within 3 hours
Within 4 hours
Within 5 hours
Within 6 hours
Greater than 6 hours
0
5
10
15
20
25
30
Number of transfers
West Midlands Neonatal Transfer Service
Transfers performedAge at Cooling centre
Within 5 hours
Within 6 hours
Within 7 hours
Within 8 hours
Within 9 hours
Within 10 hours
Within 11 hours
Within 12 hours
Greater than 12 hours
0
2
4
6
8
10
12
14
Number of babies
West Midlands Neonatal Transfer Service
Transfers performedAge 33-34°C Achieved
Within 1 hour
Within 2 hours
Within 3 hours
Within 4 hours
Within 5 hours
Within 6 hours
Greater than 6 hours
0
2
4
6
8
10
12
14
16
Number of babies
West Midlands Neonatal Transfer Service
Transfers performedMethods of cooling
Active – inactivated transwarmer
Active – cool water gloves
Passive
0 5 10 15 20 25 30 35
West Midlands Neonatal Transfer Service
Transfers performedBabies not cooled
< 33°C
> 34°C
0 1 2 3 4 5 6 7 8 9
Number of babies
West Midlands Neonatal Transfer Service
Transfers performedVentilatory support
Ventilated Ventilated + Nitric Oxide CPAP SVIA0
5
10
15
20
25
30
35
40
45
50
West Midlands Neonatal Transfer Service
Transfers performedParalysis & sedation
Morphine Morphine + Paralysis Nil0
5
10
15
20
25
30
35
40
West Midlands Neonatal Transfer Service
Transfers performedPhenobarbitone use
Phenobarb Loading Dose Phenobarb Loading + Maintenance Nil0
5
10
15
20
25
30
West Midlands Neonatal Transfer Service
Transfers performedInotropic support
Dopamine
Dobutamine
Dopamine + Dobutamine
Nil
0 5 10 15 20 25 30 35 40